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Adenotonsillectomy and orthodontic therapy in pediatric obstructive sleep apnea

Sleep and Breathing volume 18, pages 533–539 (2014)Cite this article

Abstract

Purpose

Rapid maxillary expansion (RME) is an additional treatment in pediatric obstructive sleep apnea (OSA). The aim of this study was to present data about the outcome of adenotonsillectomy (AT) and of RME in a clinical sample of pediatric OSA.

Methods

We consecutively enrolled children with OSA to undergo RME or AT. The age and the severity of OSA are the main factors involved in the choice of treatment. A polysomnography was performed at the baseline (i.e., before treatment, T0) and 1 year after treatment (T1).

Results

A total of 52 subjects fulfilled the inclusion criteria. Twenty-five children underwent AT (group 1) and 22 children underwent RME (group 2). Five children underwent both treatments (group 3). Children in group 2 were older, had a longer disease duration, a higher body mass index (BMI), a lower apnea–hypopnea index (AHI), and a lower arousal index at T0 than children in group 1. After 1 year, BMI percentile and overnight mean saturation increased in group 1 while AHI and arousal index decreased. In group 2, mean overnight saturation increased while AHI decreased. Children in group 3 displayed a significant decrease in AHI from T0 to T1.

Conclusions

Our data demonstrate that both treatments help to improve OSA, and a multidisciplinary approach to treatment is suggested.

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Author information

Affiliations

  1. Neuroscience, Mental Health and Sense Organs Department, Pediatric Sleep Disorder Centre, Faculty of Medicine and Psychology, “La Sapienza” University, Rome, Italy

    Maria Pia Villa, Rosa Castaldo, Silvia Miano, Maria Chiara Paolino, Ottavio Vitelli, Alessandra Tabarrini, Anna Rita Mazzotta, Manuela Cecili & Mario Barreto

  2. Sleep Disorder Centre, Sant’Andrea Hospital, Via Grottarossa 1035/1039, 00189, Rome, Italy

    Maria Pia Villa

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  1. Maria Pia Villa
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  2. Rosa Castaldo
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  3. Silvia Miano
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  4. Maria Chiara Paolino
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  5. Ottavio Vitelli
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  9. Mario Barreto
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Correspondence to Maria Pia Villa.

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Villa, M.P., Castaldo, R., Miano, S. et al. Adenotonsillectomy and orthodontic therapy in pediatric obstructive sleep apnea. Sleep Breath 18, 533–539 (2014). https://doi.org/10.1007/s11325-013-0915-3

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  • DOI: https://doi.org/10.1007/s11325-013-0915-3

Keywords

  • Adenotonsillectomy
  • Obstructive sleep apnea
  • Children
  • Orthodontic therapy
  • Treatment
  • Follow-up